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General NPI Number Information
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NPI Number | 1538246533
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Entity Type | Individual
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Provider Name | TAMARA GAIL SANTA ANA D.C.
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Gender | Female
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 08/05/2011
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Provider Practice Location Address
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Address Line | 17 A SOUTH RANDOLPH STREET
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City | LEXINGTON
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State | VA
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Zip | 24450-2432
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Country | US
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Telephone | 540-463-2462
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Fax | 540-463-2469
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Provider Business Mailing Address
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Address Line | 17 A SOUTH RANDOLPH STREET
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City | LEXINGTON
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State | VA
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Zip | 24450-2432
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Country | US
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Telephone | 540-463-2462
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Fax | 540-463-2469
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number | 0104001369
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License Number State | VA
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